I’ve had a meditation practice for about 20 years, have done a number of long-term retreats, and in the last 4-5 years have incorporated MCTB and other mind-map/pragmatic Buddhism approaches into my daily practice. I’m 39 y/o and healthy. However, lately I’ve been struggling with insights/experiences around actual, physical suffering.

4 years ago, I got walking pneumonia. I had to spend about 2 months in bed, barely able to walk down the stairs without running out of breath and getting dizzy or lightheaded. Any physical activity took effort. Now, each year it seems that when winter comes around, the center of my chest feels heavy. I exercise 3-4 days/week, eat healthy, and do whatever I can to fend off the onset of the symptoms, but it's mid-November and I am starting to feel an ongoing heaviness in my chest.

Lately, the physical suffering has become the main focus of my meditation. The process of noting naturally draws my attention to the rise and fall of the breath, and the moment-by-moment awareness of the body’s struggle provides a natural focus point for insight into the impermanent nature of existence. What’s strange is that the noting technique usually leads to a breakdown in attachments to mental objects in the context of my normal meditation practice, but in the case of a physical illness the breakdown does not occur because the suffering remains i.e. meditation is not going to magically heal me. That being said, the heaviness seems to be exacerbated by life stress, so mindfulness does help in daily life.

What I’m finding is a profound shift in my practice and consciousness/awareness. There is this capacious sense of emptiness. The suffering in the center of the chest feels like it expands to encompass the entirety of my awareness. Sometimes, a kind of light blue color is associated with it if I'm in a deeper state of meditation for more than 1 hour. There is a mild sense of pleasure accompanying a feeling of "letting go" and acceptance. It also feels in a way like an encounter with death, as if I am experiencing this abyss emanating from my chest and expanding out. Life is suffering, you are going to die, this is unavoidable and you must accept the nature of existence, the ego cannot use its tricks to escape/deny, etc. This, in turn, leads to a radical sense of non-duality, as if the empty quality merges with, or extends to, the realm of all phenomenon, so that everything becomes formless awareness.

I associate this more with emptiness and some of the Tibetan or Zen teachings than with Theravada/Vipassana. All of my practice up to this point has been with the operating assumptions of a healthy body, and it's as if the center of my awareness/practice is now shifting from the mind to the heart, and away from cultivating insight into a more radical non-dual awareness. I’m wondering if anyone here has had experience dealing with pain or physical suffering, how you balance/approach in your practice, and also what advice or books you might recommend.

Hi David,

I can tell you what I personally do, but I'd like to hear some opinions of some of the more experienced members on the message board too. When I'm having discomfort associated with a medical condition, I first just make sure I'm doing what I'm supposed to be doing to take care of myself physically. Sometimes even after that though, there is still pain and discomfort.

It sounds like you are managing to use this pain and discomfort to continue in your practice. I personally have had good lessons about the aspects of constant change and that suffering is a part of life through observation of pain, and the observation of how I react to pain.

I just observe moment to moment, how that pain changes, and if I can observe the subtleties that compose the pain that I feel. I find that the pain may not actually be as I once perceived it a moment ago. Many times with persistent pain, I really have to focus on just observing my object and not get carried away with feelings of aversion.

I would recommend you continue just as you have been, remaining as relaxed as possible, observant and interested. I too have been meditating primarily on pain for quite a while now. It can be a demanding object for our attention, incessant and violent at times. I've slowly adopted the posture of a mother towards a beloved child in terms of how I reflect upon it when I do reflect upon it. Mostly I simply embrace it and listen. It is the voice of one of or all three of the great teachers; old age, sickness and death.

Sometimes, in that embrace, the beloved child will slip away for a time and amuse itself elsewhere. I then relax a bit and unify my attention more conventionally. Soon the child returns and we sit and I listen.

The pain may either subside somewhat or not, depending as usual on many interdependent conditions. In my case one aspect of the conditions involved is a disk in my upper spine that presses in on the central nerve. Apparently the pain is something like the pain associated with a difficult childbirth. There is very little that can be done about it. This kind of pain circulates inside the nerve pathways and traumatizes almost the entire body 24/7. Its very interesting to observe how it moves. I usually wake up feeling like I've been sleeping on the interstate highway while transport trucks rolled over me all night. But it is nice to sleep some.

Doctors couldn't help. I went to specialists for about six months. About eight months in I had some scans and saw a neurologist who explained about the disk and the central nerve and that made sense. All along I continued to embrace the pain and give it my full attention. At about nine months it just started to taper down in intensity significantly. Not sure exactly why but the impression I have is that by giving the pain my complete unreserved attention I had more or less exhausted its compulsion to be heard. Which is a silly idea really. More likely the nerve pathways simply can't sustain that much activity long term and started to die off internally. That is probably what is happening now. All very interesting.

I'm looking forward to death, not anxiously, just looking forward to watching it happen if at all possible. That will be very interesting. I've died a couple times already in this body but not for long enough to really get a good feel for being dead again. My impression so far is that, at least initially, it is not so much of a change from existing in this way. Slightly more like existing in a dream but not quite exactly like that either.

[The Following is Later Edited] I almost forgot to add something I was going to mention about emptiness. I prefer 'the void' or 'not existence' but whatever is fine. I simply wanted to add that the Pali Canon discourses proper do touch on the void but do not enter into any metaphysical commentaries about the void in the ways that the Mahayana since has. I think there are good reasons for this as metaphysical contentions have absolutely no bearing on that which does not exist. What I can tell you about the void, about that which does not exist is that it is least to be feared of all things and that you will profit from 'knowing it' although that is not quite possible in any sense that we know that which we can contact. However the mind, having entered into its own complete non existence for some time will attempt to represent its direct knowledge of its temporal or intermittent, insubstantial or immaterial, and non-essential or center-less/core-less nature by somehow reflecting an approximation of that voidness or signlessness or emptiness.

[Note on: The 3 types of the kind of signs/symbols/logos for/consciously perceived or perceptible mental representations of/immaterial fabrications which represent; "suññata" in Pali. The sign for the voidness/emptiness appears in an important doctrine of three doors of liberation: the signless (animitta), the wishless (appanihita), and emptiness (suññata).]

Further, the percipient quality, consciousness or "supreme nutriment" (in kamma/karma making - fabrications of and for being and becoming) once having surrendered to the void - nirodha samapatti - the mind will, in due course, abandon entirely the self constructing efforts having cognized directly the falseness of self fabrications within all of that, and all of the other conditions, internal and external (conformity knowledge), will slowly begin to appear more correctly, just as these are. So don't fear the void or the not existing, its a very good not thing aside from being the only not thing.

Anyways, old age, sickness and death are not referred to as the great teachers for no good reasons. You could not hope to find more skillful and dedicated teachers, I'm sorry to have to say.

I wish for you wellness, and peace in any event.
-nathan

[Notes on:
Voidness - Emptiness - suññata - s(h)unyata

Redacted From:
http://www.dharmaoverground.org/web/guest/discussion/-/message_boards/message/78202
Forum: Dharma Overground Discussion Forum

marigpa;
I am interested in determining the provenance of this sutta,
MN 121 Cula-suññata Sutta: The Lesser Discourse on Emptiness
and and the date of the earliest written record of it in Pali. Can anyone help?
Also, the Pali word written here as "suññata" -- does it have the same meaning as "s(h)unyata" i.e. the sunyata/emptiness as used, for example, in the Prasangika Madhyamaka school?

Hokai, Florian;
Yes the word is etimologically the same as Sanskrit "shunyata", but there is some difference in the way it is understood in Theravada, some of which may be apparent from the text itself. Technically, Theravada doctrine prefers "anatta", and does not refer strictly to the emptiness of phenomena. Maybe Daniel would have more on the conceptual subtleties.

As to the earliest record of it in Pali, this is a complex issue. The oldest strata is found in the texts like Dhammapada, Itivuttaka, Udana and Sutta-nipata, featuring collections of verses, or extremely pithy teachings. Though some believe the suttas were recited by Ananda shortly after Buddha's parinibbana in the same form as we find them recorded in writen form much later, modern research does not support such opinions. The writen forms evolved probably around first two centuries B.C. and became established until 1st or 2nd century AD. Whatever be the case, emptiness is already mentioned in Dhammapada and Suttanipata, but far from being so prominent or elaborate as in Madhyamaka or Yogacara. I hope this helps somewhat.

A note on "suññata" in Pali. The term appears in an important doctrine of three doors of liberation: the signless (animitta), the wishless (appanihita), and emptiness (suññata).

It's found in the Majjhima Nikaya collection (Middle Length Discourses) of the Sutta-pitaka in the Pali Canon, under number 121. The title translation by Bhikkhus Nanamoli and Bodhi is "The Shorter Discourse on Voidness". Summary: The Buddha instructs Ananda on the "genuine, undistorted, pure descent into voidness".

You can read it on the web in translation by Thanissaro here:
http://www.accesstoinsight.org/tipitaka/mn/mn.121.than.html

See here an article by Bhikkhu Bodhi that puts it in the context of transcendental arising:

http://www.accesstoinsight.org/lib/authors/bodhi/wheel277.html

Here is a take (from a Theravada perspective) on the whole issue:

http://www.accesstoinsight.org/lib/authors/thanissaro/authenticity.html

And here is a recording of a day-long workshop ( by the same author, on the subject of emptiness and the evolution of the idea in several schools (from a Theravada perspective):

http://www.audiodharma.org/talks/ThanissaroBhikkhu.html

marigpa;
Hokai, Florian, thank you so much, I found your posts extremely helpful.

My query stemmed from reading an exchange between a couple of people on another forum, where whether the Buddha had taught Emptiness seemed to be in dispute. One person (A) cited "The Shorter Discourse on Emptiness" to demonstrate that the Buddha had indeed taught on Emptiness -- but it transpired that the other person ( had really been referring to Emptiness as explained in the Heart Sutra, seeming to be of the opinion that Nagarjuna rather than the Buddha may have been the originator of the Sunyata doctrine, and then went on to chastise person A for his style of posting, not demonstrating the provenance of what he was citing etc. So I was intrigued, and thought I'd ask the scholars on this forum!

Florian, I found listening to Thanissaro Bikkhu very helpful -- I listened to his "Emptiness Revisited" talk and got clear (at least at the time!) on what was empty of what, if you see what I mean. I liked the way he talked about refining the perception further and further to be able to perceive subtler and subtler disturbances. And the first part of his "When you know for yourselves ... " gets to the heart of the issue of provenance and authenticity, so thanks for providing a link to that.

Hokai, thanks for the links you provided. I had already skimmed through Thanissaro Bikkhu's translation of "The Shorter Discourse ...", but hadn't really picked up on the way suññata is understood differently in Theravada, as opposed to the sunyata of Madhyamaka. After reading you saying that differences ".. may be apparent from the text itself.", a closer reading brought that home to me, and Thanissaro Bikkhu's talk further clarified that. The other article re. Transcendental Arising will have to wait probably until Sunday when I'll have some more time.

Once again, thanks to you both.
Marigpa]

Dear David,

I've been suffering with medically untreatable chronic pain for most of my life. It's one of the things that drew me to meditation for sure. Until recently, when I was in pain, I would simply take the pain as my object and watch is dissolve, watch the suffering, etc. I also found it very useful to focus on the aversion to the physical pain in addition to the physical sensations as this reveals the mental aspects of pain. It helps to have strong concentration to do this well and not to get caught up in the aversion. Concentration practice is also nice when you need a break from experiencing the pain, especially doing concentration on some flavor or love or equanimity.

However, recently I have had a number of breakthroughs in my practice dealing with physical pain based on a comment in MCTB about the three valences of sensation (painful, neutral, pleasurable). Basically, the instruction is to avoid focusing only on one of these types of sensations, but to include all three. I started noticing that I have developed a bias toward using the painful sensations as my object. They are always the most prominent and easily noticeable for me, so it's natural for my mind to gravitate to them. To correct this tendency, over the last sever weeks, I've adopted the practice of explicitly shifting between the different valences. I resolve first to notice only the painful sensations in my field of awareness, then to notice only the neutral, then to notice only the pleasant. It's sort of like a RGB color photo being split into it's three colour spectra. After cycling between the three for a while, I'll start chording them in the three combinations, so I'll do pain+neutral, then pain+pleasant, than neutral+pleasant. Finally, I'll include all three at once. After practicing this sequence for a while, I find it much easier to be aware of painful sensations while simultaneously being aware of pleasant and neutral sensations. What's amazing is that with time I've noticed that there are pleasant, painful, and neutral sensations throughout the field of awareness. Even in the midst of a very painful muscle injury, I can sense pleasant and neutral sensations. Being aware of the fact that every point in my field of awareness has painful, neutral,and pleasurable sensations has made pain much easier to deal with, and also has added a lot of pleasure and joy to my life.

This has actually helped me breakthrough to great insights in my vipassana practice, and helped heal a lot of areas of chronic physical pain in my body. I can't explain the latter, but there are a number of areas where I suffered from chronic pain for years, that no longer hurt noticeably in everyday life since I've adopted this practice.

Avi
Toronto Spiritual Direction

Hi David P,

Welcome to the forum.

I'm editing and re-posting because I didn't really address this:


1) To re-interate a point in the thread, that of metta:
TT:
So, being like an idealized parent who loves their child with patience, listening, comforting. This is so challenging, still. Just being gentle with oneself during such a difficult experience as chronic pain.

2. What I've heard or read Ayya Khema, Yuttadhammo, Goenka, Kabat-Zinn say is to try to just receive the sensations, observe their arising and passing. Myself, my own chronic pain abated a few years ago; I was inspired by the monk Thanissaro speaking of Ajahn Chah's abatement of the symptoms of malaria and so I started to sit with the pain of my own long-term sickness. When i sat with it I let go of a lot of extraneous thinking about it and slowly I also somehow started testing modifications in my behaviour off the cushion and I started eating in way that a friend here called the ketogenic diet (see below). So, while someday I expect pain from old age and/sickness will return, in this case meditation seemed to help me see my own disease state more clearly and help alleviate it.

So sometimes, from that steady meditational observation, some causality to the painful sensations occurs to oneself and helpful change in behaviour can be known. Regardless, this meditation observation of pain is like that of breathing meditation:
A. first, we just can be mindful and note the breath (or pain) -- satisampajana (awareness and understating the arising 'data')
B. then we can become discerning about the breath (or pain): is it long/short? --- patisamvedi (being aware of sensations)
C. then we can train in this, perceiving the entire body -- the training in observing and knowing the above (sikkhati (ph?))
D. then we can tranquilize the bodily sensations to some degree in just doing the above and we can train in that tranquility of breathing and clearly comprehending sensations and feeling the whole body.
(My recap of satipatthana instruction here is based on part one of Bhikkhu Bodhi's ten talks on the Satipatthana sutra provided freely by Bodhi Monastery in New Jersey. This bhante also deals with recurrent and sometimes debilitating head pain; though he does not address in that lecture, personally I think it informs his teaching.)

But, as you know, a lot of times one may not find any answer and/or cure to end the painful sensations. One just understands them better, sees them more clearly without any additive misery from affective response.

By affective response what I can say from my experience is that when I was dealing with then-chronic unpleasant sensations it was completely natural to want painful sensations to go away, that any remittance of painful sensation, such as neutral sensations, also would generate mental pleasant feeling (the happiness of relief from pain). Then I would crave i) that abatement of pain as well as ii) the new pleasure that arose in the absence of pain, the happiness of releif. So now I'd have two pains when the pain returns i) the painful sensation and ii) missing the positive mental state that arose in response to painful sensation abating.

I think you are doing what can be done: observing it, trying not to add to it emotionally. But if the desire that the pain abates arises just as much as the pains, that's natural and no fault of you/your meditation. The emotional frustration is an arising pain like the physical pain; some people do see that emotional pain go (Ayya Khema is clear that she did not suffer her cancer, but that it was a lot of unpleasant sensation), but if it does not the we can go back to metta for ourselves, this mind that also suffers the bodily pains.

3. Lastly, per above, you did not ask about it, so excuse my compulsion to give it to you: ketogenic diet. When I had exhausted a few antibiotic protocols after three years of them, including daily IV, I came across the ketogenic diet. I still do a vegan ketogenic diet-version on and off. It is used a lot for brain problems (see these related university studies and trials, if you like: UVA, U. Pittsburgh, Duke, Columbia, Johns Hopkins, Oxford). Based on what I know of deep infection and this diet in my own life, if you're not diabetic type I, then I'd try this. If you're diabetic type II, i'd consider if with the MD who is also Type II and does this diet for himself (can be found online). It made my illness something that brought me to meditation studies, and to changing how I live and enjoy my life and, in part, and understanding that there will come a time again when this personhood does not get a temporary break from that process of dying.

Best wishes and health to you,
Katy

First, thanks to everyone for the incredibly thoughtful responses, and thank you also for such a great welcome to the community.

In reading through the comments above, I think one of the things that is coming to mind is an awareness of certain hidden assumptions or blind spots that I had about my practice in relationship to goals. Specifically, I have been hoping to cultivate various states of awareness in accordance with mind maps, taking almost a cookbook-style approach to the path where certain expectations of "progress" made me think that so-called "negative" sensations (such as sickness/physical suffering) were obstacles to awakening i.e. everything should progressively get "better."

It's as if I had been trying to ignore or "note away" the suffering, like by acknowledging it I could move on, and in moving on I could get back to achieving my goals of attaining further levels of insight. As many of you pointed out, sickness, old age and death are great teachers. The advice to approach sickness like a child is incredibly helpful. What I'm finding is that when I stop being attached to preconceived notions about progress and where I need to fit on a map, the awareness of the suffering is bringing not only a deeper sense of insight, but also there is a very profound merging of insight with compassion. This shift in my practice has led me to feel more kind, mindful, and attentive to the needs of others. I'm becoming more conscious of suffering, and the metta aspect of the practice is permeating my life on and off the cushion.

What initially felt like an obstacle is now turning into a breakthrough as sensations rise and fall without attaching any judgment in terms of them being positive, neutral, and negative - they are all just aspects of awareness.

:-) Hi David!

Not sure if you would also infer this from the above excellent posts, but one can also send or direct loving-kindness to those parts of the body that are in pain (if not too fatigued or overwhelmed by agony) or tense. It's like sending a warm loving smile to those areas, being kind to them, with benign patience. This is isn't taking time out from 'real practice' but is in accord with practising Right Intention, which includes kindness to yourself.

A more formal routine is the Taoist Inner Smile meditation, of which various examples exist. One can draw on these and adapt to suit. It is basically an 'energetic' own-body-focused practice of the brahma-viharas of metta, karuna and mudita. This activity does not stand in opposition to practising mindfulness/cultivating awareness and sensitivity, but operates with it.

A couple of examples of Inner Smile routines follow...
Mantak Chia
DeeperMeditation.net audio

All the best with your spiritual practice (-:

I found / Mantak Chia esp. insightful re:many things...